A case of melena and perforation during chemotherapy for peripheral T-cell lymphoma, not otherwise specified of the small intestine

Abstract

A 71-year-old male presented with gastrointestinal bleeding. Double-balloon endoscopy revealed diffuse thickening of the wall and a shallow ulcer measuring approximately 10cm in the mid jejunum. Biopsy revealed diffuse proliferation of large lymphoid cells that were immunohistochemically positive for CD3, CD5, and bcl-2 but negative for CK, CD10, CD20, and bcl-6. The cyclin D1 labeling index was 3% and the MIB-1 labeling index was 61%. On the basis of these findings, he was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) of the small intestine. Following four courses of THP-COP chemotherapy, he developed intestinal perforation and underwent partial resection of the small intestine. He is currently undergoing further chemotherapy.